Aug 1, 2017

Tom Price's unprecedented predicament

Lazaro Gamio / Axios

It's hard to think of another Cabinet secretary in recent memory who's been as hostile to part of his duties as Health and Human Services secretary Tom Price is to overseeing the Affordable Care Act.

  • Most new administration come in with some reservations about their predecessors' policy decisions and aims to nudge things in a new direction — but that's hardly the same thing as producing P.R. materials attacking a law you're supposed to be implementing, and reportedly using money set aside to promote that program.
  • "If you believe in the rule of law, then those reservations notwithstanding, the executive branch has a duty to execute the laws," said William Galston, who served in the early days of the Clinton administration and now chairs the governance studies program at the Brookings Institution.

Price has been one of the administration's loudest critics of the ACA, and HHS has disparaged the law even in updates about its progress. But it's still up to HHS and the IRS to carry out the ACA's most significant provisions.

For context:

  • Democrats never loved Medicare Advantage, the partially privatized program created under the George W. Bush administration, and didn't love the structure of Medicare's prescription-drug benefit, either.
  • But when President Obama came into office, his administration carried out those programs relatively normally. It tried to cut Medicare Advantage payments a few times, but it didn't run ads or put top officials on TV trying to discourage enrollment. The parts of the drug benefit it didn't like were changed in the ACA.
  • The closest parallel, Galston said, would be the tug-of-war between administrations at the Environmental Protection Agency, which has been sued in the past for refusing to carry out responsibilities it had been tasked with. If Price goes that far, he also could face the threat of legal action.

Yes, but: "This is an unusual case," said Mark McClellan, who oversaw Medicare, Medicaid and the FDA during the Bush administration, citing the problems the ACA has experienced on the ground — even with the Obama administration's aggressive effort to make it work as well as possible.

"This has been a little bit more fragile," he said. "To me what seems likely is markets continuing to limp along in some states unless administration decides to do something much more active" to disrupt those markets.

Go deeper

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 8 a.m. ET: 679,977 — Total deaths: 31,734 — Total recoveries: 145,625.
  2. U.S.: Leads the world in cases. Total confirmed cases as of 8 a.m. ET: 124,686 — Total deaths: 2,191 — Total recoveries: 2,612.
  3. Federal government latest: Trump announces new travel advisories for New York, New Jersey and Connecticut, but rules out quarantine enforcement. Per CDC, those residents should "refrain from non-essential domestic travel for 14 days," with the exception of critical infrastructure industry workers.
  4. State updates: Alaska issues a stay-at-home order — New York tries to nearly triple hospital capacity in less than a month and moved presidential primary to June 23. Some Midwestern swing voters who backed Trump's initial handling of the virus balk at call for U.S. to be "opened up" by Easter.
  5. World updates: In Spain, over 1,400 people were confirmed dead between Thursday to Saturday.
  6. 🚀 Space updates: OneWeb filed for bankruptcy amid the novel coronavirus pandemic.
  7. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk
  8. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

The year of the protest meets the year of the lockdown

Hong Kong demonstrators protest a government ban on face masks in October. Photo by Laurel Chor/Getty Images

The year of the mass uprising has collided with the year of the coronavirus lockdown, leaving protest movements around the world stalled. 

The big picture: The enduring images of 2019 are of protest — from Hong Kong to Khartoum, across the Middle East and through much of Latin America. Seemingly overnight, though, social distancing has made such mass demonstrations almost unthinkable.

Go deeperArrow1 hour ago - World

Coronavirus updates: Global death toll tops 30,000

Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC, and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens and confirmed plus presumptive cases from the CDC

The novel coronavirus has now killed more than 30,000 people around the world — with Italy reporting over 10,000 deaths, per Johns Hopkins data.

The big picture: The number of deaths from COVID-19 in the U.S. surpassed 2,000 on Saturday. The United States leads the world in confirmed coronavirus infections — more than 124,000 by early Sunday. The number of those recovered from the virus in the U.S. passed the 1,000-mark on Saturday evening.

Go deeperArrowUpdated 5 hours ago - Health